Healthcare Provider Details

I. General information

NPI: 1568579407
Provider Name (Legal Business Name): DREW NELSON SOMMERVILLE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2006
Last Update Date: 09/08/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6149 E COLUMBIA ST
EVANSVILLE IN
47715
US

IV. Provider business mailing address

6149 E COLUMBIA ST
EVANSVILLE IN
47715-9134
US

V. Phone/Fax

Practice location:
  • Phone: 812-424-2020
  • Fax: 812-424-3000
Mailing address:
  • Phone: 812-424-2020
  • Fax: 812-424-3000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number036124386
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number41117
License Number StateKY
# 3
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number01066351A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: